Breastfeeding in emergencies

Natural disasters as well as man-made emergencies are inevitable. Breastfeeding is a main precaution mothers can take in order to secure their childrens health and well-being in all circumstances. Artificial infant milks can be unavailable or it may be impossible to prepare or feed it safely. In the coming cold season it can easily happen to get struck in traffic for longer then planned. Make sure there's always a clean set of diapers and clothing in the car, as well as lots of drinking water and a blanket for each person. For infant and toddler food and drinks in the form of breastfeeding are ready available. Make sure to feed often to avoid dehydration and to ensure sufficient milk production. In the event of major natural disasters like earthquakes or floods, when it may take quite some time for help to arrive and the supply of fresh water and energy may be out of order for prolonged periods, breastfeeding is the best care for young children. Unlike the common beliefs stress will not dry milk up or prevent women to breastfeed and women who were not breastfeeding prior the the disaster can relactate. 
http://www.wellstart.org/Infant_feeding_emergency.pdf

Immunisation

Breastfeeding protects children against all kinds of diseases the mother has lived through and that the child himself colonizes his mother with. Research showed that maternal vaccination also protects her child. Eick et al found that the breastfed children of mothers who got a seasonal flu shot showed less influenza or influenzlike symptoms during the first half year of life. Vicor c.s. conducted a very interesting study that showed that preconceptional maternal immunisation can protect a child via breastfeeding to develop allergies. Maternal immunization with ovalbumin upregulates the inhibitory FcγRIIb expression on offspring B cells, avoiding skewed Th2 response and development of allergy. These findings contribute to the advancement of prophylactic strategies to prevent allergic diseases in early life. This might be a better prevention of allergies then the premature (between 4 and 6 months) introduction of solids.
Eick AA; Uyeki TM; Klimov A; Hall H; Reid R; Santosham M; O'Brien KL: Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infants. Arch Pediatr Adolesc Med. 2010;0(2010):archpediatrics.2010.192.
Victor JR, Muniz BP, Fusaro AE, de Brito CA, Taniguchi EF, Duarte AJS, Sato MN: Maternal immunization with ovalbumin prevents neonatal allergy development and up-regulates inhibitory receptor FcγRIIB expression on B cells. BMC Immunology 2010, 11:11

Education, ethnicity and breastfeeding

The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study focuses on 4 primary areas of research: growth and physical development; behavioural and cognitive development; diseases in childhood; and health and healthcare for pregnant women and children. In total almost 10,000 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Sub-studies looked at breastfeeding. Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. These findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries. These goals however were not reached by the research subjects (mothers and children from all over Rotterdam from all backgrounds and classes). Especially the most vulnerable children, those with lowest-educated mothers, were less likely to start breastfeeding (73% compared to (95% for those with highest-educated mothers) and for shorter duration (15% breastfed up to 6 months, compared to almost 40% for highest educated mothers).  Also ethnicity is a determining factor for breastfeeding initiation and continuation. More non-native mothers started breastfeeding than native mothers, but relative fewer continued. In both native Dutch and non-native mothers breastfeeding continuation rates are low.
van Rossem L, Oenema A, Steegers EAP, Moll HA, Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Are Starting and Continuing Breastfeeding Related to Educational Background? The Generation R Study. Pediatrics 2009 123: e1017-e1027
Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Breastfeeding patterns among ethnic minorities: the Generation R Study. J Epidemiol Community Health jech.2009.Published Online First: 8 December 2009
Duijts L, Jaddoe VWV, Hofman A, Moll HA: Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy. Pediatrics 2010 126: e18-e25

Breastfeeding and contraception.

Women who breastfeed are less likely to use hormonal contraceptives. Within 6 weeks after weaning to artificial infant food many women in the Van Wouwe et al study start oral contraceptives (OCP). The researchers advise to include more attention is given to this aspect that may decrease breastfeeding duration in the  BFHI (Baby Friendly Hospital Initiative) materials. According to the outcomes of the review of the literature Kapp c.s. conducted this fear for OCP may be unnecessary.  In multiple studies they found no evidence of possible negative effects of progestogen only OCP’s; the evidence for safety for the breastfed child was less strong, due to methodologically limited studies. Who none the less wants to avoid OCP’s modern fertility awareness-based methods (FABMs) of family planning are a valid option. Pallone & Bergus urge family physicians to get more expertise in counselling their patients is these methods.
Van Wouwe JP, Lanting CI, Van Dommelen P, Treffers PE, Van Buuren S: Breastfeeding duration related to practised contraception in the Netherlands. Acta Pædiatrica 2009, 98(1):86-90
Kapp N, Curtis K, Nanda K: Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception 2010, 82(1):17-37.
Stephen R. Pallone SR and George R. Bergus GR: Fertility Awareness-Based Methods: Another Option for Family Planning. J Am Board Fam Med 2009; 22: 147-157

Herbs and breastfeeding

Breastfeeding not always comes easy and many mothers find they have to tackle bumps and sills and fight wolves and bears to get and keep breastfeeding going. There are, though, all kinds of devices and techniques they can use to aid them in their quest. Many people like to turn to herbal remedies to do so, while others say that won’t work. Fecka & Turek testd how much of the active substance gets into the fluid if you make tea of peppermint, melissa or sage. Thy actually found he amounts of it in the teas. While rsearching sage Gali-Muhtasib founds this not only to be a strong lactation inhibitor, but to have anti-inflammatory and antimicrobial properties as well as being a strong anticancer agent. Melli at al in their search for the use of peppermint in sore nipples found that women who applied peppermint gel rather than lanolin or a placebo gel showed less nipple damage after two weeks of preventive application. They urge to teach women proper techniques as well as prophylactic use of peppermint gel.
Fecka I,  Sebastian Turek S: Determination of Water-Soluble Polyphenolic Compounds in Commercial Herbal Teas from Lamiaceae: Peppermint, Melissa, and Sage. J. Agric. Food Chem., 2007, 55 (26), pp 10908–10917
Gali-Muhtasib H: Anticancer and medicinal properties of essential oil and extracts of East Mediterranean sage (salvia triloba). Advances in Phytomedicine 2006, 2:169-180
Melli MS, Rashidi MR, Nokhoodchi A, Tagavi S, Farzadi L, Sadaghat K, Tahmasebi Z, Sheshvan MK: A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit. 2007 Sep;13(9):CR406-411.

A good start

The last decennia much has changed in the perinatal care and the routines have become  breastfeeding friendly. An important development was that children were not taken away from their mothers right away and that children could stay in mom’s room. More recently the importance of skin-to-skin contact is being recognised and most babies are allowed to spend some time undressed on their mothers’ tummies right after they are born. Research shows that skin contact good is for babies, for the initiation of mother-baby bonding and the initiation of breastfeeding. Moore & Cranston Anderson found a difference in the early days of breastfeeding, but not after a month. Olson et al found in their research that the decrease in breastfeeding after some weeks, despite intensive counselling and instruction, may very well be caused by the cessation of skin-to-skin position after the 1e hour postpartum and the first breastfeeding. She found that human infants ar not dorsal feeders (with pressure needed along the baby's back), but rather abdominal feeders and, like many other animals. In the prone position they show a diversity of reflex activity aimed at searching and finding the breast, latching on and maintaining milk flow. This way of breastfeeding (Biological Nurturing) prevents much of the ‘’fighting at the breast’’ behaviour many infants show at being put to breast and it enhances effective and do-it-yourself latching on.
Colson SD, Meek , Jane M. Hawdon JM: Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development 2008, 84(7):441-449.
Moore ER, Cranston Anderson G: Randomized Controlled Trial of Very Early Mother–Infant Skin-to-Skin Contact and Breastfeeding Status. Journal of midwifery & women's health 1 March 2007 (volume 52 issue 2 Pages 116-125

Vintage

Vintage means giving old things a new meaning. Biological Nurturing is as old as (wo-)mankind en Suzanne Colson puts it forward as a new means of looking at breastfeeding. As superb as vintage styling. From the preface: ‘’ Most health professionals believe that mothers need to be taught how to breastfeed. An Introduction to Biological Nurturing describes new research evidence suggesting that mothers and babies innately know how to breastfeed, and introduces a new approach called biological nurturing. Biological nurturing is a collective term for optimal breastfeeding states and positions whose interaction release spontaneous behaviours helping mothers and babies get started with feeding. Biological nurturing is quick and easy to do. Most moms and babies automatically move into the correct positions if left on their own. The challenge for health professionals lies with understanding the releasing mechanisms and learning how to help mothers and babies do what comes naturally. This book restores confidence in nature's biological design and in mothers' innate capacity to breastfeed.’’
Colson S: An introduction to Biological Nurturing; new angles on breastfeeding. Hale Publishing, Amarillo TX, USA, 2010